Analysis of the Survival Rate with Cervical Cancer Using ¹³⁷Cs and ¹⁹²Ir Afterloading Brachytherapy

OBJECTIVE To analyze and compare the survival rate for stages II and III cervical cancer treated by external Irradiation plus ¹³⁷Cs or ¹⁹²Ir.

METHODS The patients with cervical cancer were treated by external irradiation plus ¹³⁷Cs (group A, 427 patients) or plus ¹⁹²Ir (group B, 156 patients). There were 170 stage II cases and 413 stage III cases. The number of cancer types were as follows: squamous cell carcinoma, 524; adenocarcinoma, 34; and adenosquamous cell carcinoma, 25. The two groups received the same external irradiation using 8 or 10 MV of X-ray. After the whole pelvis received 25-35 Gy, the focus was given a total of 45-55 Gy by four divided fields. Intracavitary Irradiation was performed with one fraction of 6-7 Gy In reference dose at A point every week and a total dose of 40-60 Gy with 6-8 fractions for group A; every fraction of 5-6 Gy In reference dose of A point and total dose of 30-42 Gy with 5-7 fractions for group B.

RESULTS The 5-year survival rate of stage II and III, and total were 82.9%, 62.2%, and 67.2% for group A respectively and 85.1%, 61.5% and 69.2% for group B respectively. There were significant differences between stage II and III in each group (P< 0.05) but there were no differences in the 5-year survival rate between the two groups (P> 0.05). The late complications of the therapy were rectitis and urocystitis and with an incidence rate of 7.3% and 6.3% for group A and 9.6% and 9.0% for group B (P > 0.05).

CONCLUSION The long-term survival rate and complications of stages II and III cervical cancer are similar when treated with external Irradiation plus ¹³⁷Csorplus ¹⁹²Ir.